上海市杨浦区2009—2013年手足口病流行特征分析
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杨浦区疾病预防控制中心,杨浦区疾病预防控制中心,杨浦区疾病预防控制中心,杨浦区疾病预防控制中心,杨浦区疾病预防控制中心,第二军医大学热带医学与公共卫生学系流行病学教研室,杨浦区疾病预防控制中心

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Hand, foot and mouth disease in Yangpu District of Shanghai: an analysis of epidemiologic characteristics in 2009-2013
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Yangpu district center for disease control and prevention,,,,,,Yangpu district center for disease control and prevention

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    摘要:

    目的 分析杨浦区2009至2013年手足口病的流行病学和病原学特征,为手足口病的防治提供科学依据.方法 利用国家疾病监测信息管理系统开展手足口病监测,采用描述性流行病学方法对杨浦区2009至2013年手足口病监测资料和部分患者病原学监测结果进行统计和分析,采用实时荧光PCR方法对部分手足口病例进行肠道病毒(enterovirus,EV)核酸检测.结果 2009至2013年,杨浦区累计报告手足口病病例4 974例,年均发病率为75.53/10万,累计报告重症病例9例,占报告病例的0.18%,无死亡病例;发病的高峰期集中在4~7月,流行高峰呈逐年升高的趋势,且高峰有延迟现象;各街道的发病率随着时间的推移呈逐年上升的趋势(Ptrend<0.05),各街道每年发病率有所不同(P<0.05);人群的发病特征以5岁及以下的散居和幼托儿童为主;2010年主要以EV71和Cox A16为流行株,2011至2013年主要以其他肠道病毒和Cox A16为流行株,其他肠道病毒所占比例有所增加,流行高峰前和流行高峰后病原谱曲线呈交叉现象.结论 杨浦区手足口病有明显的季节性、地区性和人群特征,不同年份间流行优势株有所差别,优势病原株的转化影响疫情流行趋势和严重程度.

    Abstract:

    Objective To analyze the etiological and epidemiological characteristics of hand, foot and mouth disease (HFMD) in Yangpu District of Shanghai from 2009 to 2013, providing evidence for its prevention and control. Methods HFMD surveillance and report were done using the National Disease Supervision Information Management System. Descriptive epidemiological method was used to analyze the 2009-2013 epidemiologic characters and etiological characters (partial patients) of HFMD in Yangpu District, Shanghai. Nucleic acid of enterovirus (EV) genome was detected by real-time PCR in some patients. Results A total of 4 974 cases of HFMD were reported during 2009-2013 in Yangpu District, Shanghai, with the average annual incidence rate of 755.3 per million, with no death cases and 9 (0.18%) severe cases. The peak incidence was observed in the period of April to July. The epidemic peak had an increasing tendency and could be delayed. The incidence rates of HFMD were increased at an annual basis(Ptrend<0.05) in all communities and were significantly different between different communities (P<0.05). Most of the cases were less than 5-year-old scattered and childcare children. The main epidemic strains were EV71 and Cox A16 in 2010, and other enterovirus and Cox A16 in 2011-2013. The proportions of other enterovirus strains were increased, with overlapping phenomenon found in the pathogenic spectrum curves before and after the epidemic peak. Conclusion The 2009-2013 epidemiology of HFMD in Yangpu District of Shanghai had prominent seasonal, regional and population characteristics. Epidemic superiority strains vary annually and influence the epidemic trend and severity.

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  • 收稿日期:2014-06-22
  • 最后修改日期:2014-09-25
  • 录用日期:2014-11-18
  • 在线发布日期: 2015-01-21
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